DMI-30-Form-Payment-Package-or-Final-with_Invoices_SLBE_ADA.pdf

PDF 197 KB Posted Apr 21, 2026

Attached to: Irrigation Services (Bid Discount)
Solicitation number: 26-P-00279
Issued by: Hillsborough County, Florida

About this file

Written by GovTribe AI · Apr 29, 2026

This is a DMI-30 Payment Form used by the City of Tampa, Florida to track and document payments made to subcontractors, consultants, and suppliers on city contracts. The form serves as a compliance document required under Ordinance 2008-89 and must be submitted with all invoicing or payment requests whenever subcontracting work has been performed during a pay period. The form captures essential contract information including the contract number, work order number, contract name, contractor identification details, pay period dates, payment request sequence number, and the responsible city department. Contractors must provide a comprehensive accounting of all subcontractor payments, including total contract amounts with any change orders, amounts previously paid to date, amounts pending from prior reporting periods, and amounts being requested for the current period. The form includes specific fields for up to six subcontractors or suppliers and requires documentation of SLBE (Small Local Business Enterprise) or other ownership classifications for each vendor.

Completion and submission of the DMI-30 form is mandatory, and failure to properly complete, sign, and date the document may result in non-compliance determinations. Supporting documentation must accompany the payment form, including "Waiver and Release of Lien upon Progress Payment," "Affidavit of Contractor in Connection with Final Payment," or an affidavit of payment after subcontractor payments have been made. The form requires certification by an authorized representative that all information provided is true and accurate. Questions regarding form completion or submission requirements should be directed to the City of Tampa's Office of Equal Business Opportunity at (813) 274-5522. The form is applicable to the Irrigation Services contract with the City of Tampa, where the primary awardee performs irrigation repair and installation services, with directional boring services allowable through in-house capabilities or subcontractors.

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Other files

File	Type	Posted
Irrigation_Services_(Bid_Discount).pdf	PDF	Apr 28, 2026
26-P-00279_Contact_list_.xlsx	XLSX spreadsheet	Apr 21, 2026
Irrigation_-_Standard_Details.pdf	PDF	Apr 21, 2026
DMI-40-Form-LOI-Letter-of-Intent_SLBE_ADA.pdf	PDF	Apr 21, 2026
Occupational_Safety_and_Health_Administration_SDS.pdf	PDF	Apr 21, 2026
ADA_Requirements.pdf	PDF	Apr 21, 2026

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Page 1 of 2 –DMI Payment City of Tampa – DMI Sub-(Contractors/Consultants/Suppliers) Payments

(DMI 30 FORM)

[] Partial [] Final

Contract No.: WO (if any): Contract Name: ____________________ Contractor Name: Address: ________________________________

Federal ID: Phone: Fax: Email: _________________ GC Pay Period: Payment Request/Invoice Number: City Department: ______________

Total Amount Requested for pay period: $____________ Total Contract Amount (including change orders): $___________ -Type of Ownership - S = SLBE, O = Other

Type, Federal ID

Company Name Address

Phone & Fax

Total Subcontract

Or PO Amount

Amount Paid To Date

Amount To Be Paid

For This Period

Amount Pending Previously Reported

Sub Pay Period Ending Date

(Modifying This Form or Failure to Complete and Sign May Result in Non-Compliance) Certification: I hereby certify that the above information is a true and accurate account of payments to subcontractors/consultants on this contract.

Signed: Name/Title: Date:

DMI 30 form (rev. 01/2026) Note: Detailed Instructions for completing this form are on the next page Forms must be signed and dated, or they will be considered incomplete. Failure to sign this document or return it unsigned can be cause for determining that a company is in non-compliance with Ordinance 2008-89.

Page 2 of 2 – DMI Payment Instructions for completing DMI Sub-(Contractor’s/Consultants/ Suppliers)Payment Form(DMI 30)

This form must be submitted with all invoicing or payment requests where there has been subcontracting rendered for the pay period. If applicable, after payment has been made to the subcontractor, “Waiver and Release of Lien upon Progress Payment”, “Affidavit of Contractor in Connection with Final Payment”, or an affidavit of payment must be submitted with the amount paid for the pay period.

(Modifying or omitting information from this form may result in non-compliance.)

• Contract No. This is the number assigned by the City of Tampa for the proposal.

• W.O. If the report covers a work order number (W.O. for the contract, please indicate it in that space.

• Contract Name. This is the name of the contract assigned by the City of Tampa for the bid or proposal.

• Contractor Name. The name of your business.

• Address. The physical address of your business.

• Federal ID. A number assigned to a business for tax reporting purposes.

• Phone. Telephone number to contact the business.

• Fax. Fax number for business.

• Email. Provide email address for electronic correspondence.

• Pay Period. Provide start and finish dates for the pay period. (e.g. 05/01/13 – 05/31/13)

• Payment Request/Invoice Number. Provide a sequence number for payment requests. (ex. Payment one, write 1 in the space, payment three, write 3 in the space provided.)

• City Department. The City of Tampa department to which the contract pertains.

• Total Amount Requested for the pay period. Provide all the dollars you are expecting to receive for the pay period.

• Total Contract Amount (including change orders). Provide the expected total contract amount.

• Signed/Name/Title/Date. This is your certification that the information provided on the form is accurate.

• See attached documents. Check if you have provided any additional documentation relating to the payment data. Located at the bottom middle of the form.

• Partial Payment. Check if the payment period is a partial payment, not a final payment.

• Final Payment. The check for this period is the final payment period.

The following instructions are for the information of all subcontractors used for the pay period.

• (Type) of Ownership. Indicate SLBE or Other.

• Federal ID. A number assigned to a business for tax reporting purposes.

• Company Name, Address, Phone & Fax. Provide company information for payment verification.

• Total Subcontract Amount. Provide the total amount of subcontract for the subcontractor, including change orders.

• Amount Paid to Date. Indicate all dollars paid to date for the subcontractor.

• Amount Pending, Previously Reported. Indicate any amount previously reported for which payments are pending.

• Amount To Be Paid for this Period. Provide the dollar amount requested for the pay period.

• Sub Pay Period Ending Date. Provide the date for which the subcontractor invoiced for the work performed.

If any additional information is required or you have any questions, you may call the Office of Equal Business Opportunity at (813) 274-5522.

Contract No:

WO if any:

Contract Name:

Contractor Name:

Address:

Federal ID:

Phone:

Fax:

Email:

GC Pay Period:

Payment RequestInvoice Number:

City Department:

Total Contract Amount including change orders:

Type Federal IDRow1:

Company Name Address Phone FaxRow1:

Total Subcontract Or PO AmountRow1:

Amount Paid To DateRow1:

Amount To Be Paid For This PeriodRow1:

Amount Pending Previously ReportedRow1:

Sub Pay Period Ending DateRow1:

Type Federal IDRow2:

Company Name Address Phone FaxRow2:

Total Subcontract Or PO AmountRow2:

Amount Paid To DateRow2:

Amount To Be Paid For This PeriodRow2:

Amount Pending Previously ReportedRow2:

Sub Pay Period Ending DateRow2:

Type Federal IDRow3:

Company Name Address Phone FaxRow3:

Total Subcontract Or PO AmountRow3:

Amount Paid To DateRow3:

Amount To Be Paid For This PeriodRow3:

Amount Pending Previously ReportedRow3:

Sub Pay Period Ending DateRow3:

Type Federal IDRow4:

Company Name Address Phone FaxRow4:

Total Subcontract Or PO AmountRow4:

Amount Paid To DateRow4:

Amount To Be Paid For This PeriodRow4:

Amount Pending Previously ReportedRow4:

Sub Pay Period Ending DateRow4:

Type Federal IDRow5:

Company Name Address Phone FaxRow5:

Total Subcontract Or PO AmountRow5:

Amount Paid To DateRow5:

Amount To Be Paid For This PeriodRow5:

Amount Pending Previously ReportedRow5:

Sub Pay Period Ending DateRow5:

Type Federal IDRow6:

Company Name Address Phone FaxRow6:

Total Subcontract Or PO AmountRow6:

Amount Paid To DateRow6:

Amount To Be Paid For This PeriodRow6:

Amount Pending Previously ReportedRow6:

Sub Pay Period Ending DateRow6:

NameTitle:

Date:

Total Amount Requested for Pay Period:

Partial: Off

Final: Off

File details come from the government source that posted it. Updated Apr 29, 2026.